Efficiency and productivity analysis of maternal and infant healthcare services in Sub-Saharan Africa.

The paper examines the efficiency and productivity of Sub-Saharan African (SSA) countries towards maternal and infant healthcare services between 2015 and 2019. Data envelopment analysis is utilised to evaluate efficiency, and Malmquist-Luenberger's (ML) productivity estimation is employed for productivity analysis. The results indicate inefficiency in SSA maternal and infant healthcare services. Average efficiency is pegged at 85%, and 60% of the countries evaluated had below-average efficiency. Effects of socioeconomic dynamics of countries were analysed. Preliminary estimations on the impact of Gross domestic product (GDP), education, urban population, and total population on efficiency are not significant. Although GDP and education sometimes show that they influence efficiency positively. Sensitivity analysis indicates efficiency to be more responsive to health expenditure, as well as to nurses and midwives. ML Productivity decomposition into technical efficiency change and technological change indicates improvement in technical efficiency as the principal driver of efficiency and productivity. Policy recommendations are made in line with the findings, requirements, and constraints of SSA countries.

Efficiency and productivity analysis of innovation, human capital, environmental, and economic sustainability nexus: case of MENA countries.

Innovation, human capital, economic, and environmental nexus is essential in sustainable development. The Middle East and North Africa (MENA) is an emerging market with the potential to transcend the dilemma of attaining economic and environmental sustainability. Data envelopment analysis through the Malmquist-Luenberger productivity index is utilized to estimate MENA country's innovation, human capital, economic, and economic sustainability efficiency and productivity. Results indicate an upward trend in efficiency, with a 26% increase in average efficiency between 2017 and 2019 compared to 2011 and 2016. However, there is variation in efficiency between countries. The decomposition of the productivity index into technical change and technological change indicates that the efficiency growth in 2017-2019 could be attributed to technical improvement than technological increase. However, there is a shift to more technological progress than technical increase. Study shows that developing human capital and capacity is as integral to sustainable development as innovation advancement. Strategies to simultaneously augment human capital and innovation towards sustainable development are presented.

Efficiency Analysis of Syrian Refugees' Healthcare Services in Turkey and Other 3RP States.

Access to healthcare for refugees is often contextually and conceptually diverse. This study set out to evaluate the efficiency of the healthcare services provided for Syrian refugees in Turkey and other refugee response and resilience plan (3RP) states. Data envelopment analysis is utilized for efficiency analysis using primary healthcare system indicators. Efficiency is broken down into pure technical efficiency and scale efficiency to identify causes of inefficiency. Normative analysis is used to employ a teleological approach to better understand current refugee healthcare policies. The findings show a decline in the overall efficiency for Turkey and other 3RP states. However, Turkey's operational practices could be a model for other 3RP states due to its relatively high pure technical efficiency. Scale inefficiency negatively impacts the overall efficiency of Turkey's service, while other 3RP states exhibit a rather consistent performance. The study concludes that Turkey's healthcare system for refugees is inefficient, resulting in inadequate access for Syrian refugees. As such, operational and scale efficiency must be synergized for Turkey to fulfill its obligation to provide adequate healthcare for Syrian refugees. Additionally, COVID-19 was found to have exacerbated the challenges Syrian refugees face accessing healthcare. Policy recommendations have been made in line with the findings of the study.

Integrated analysis of energy-economic development-environmental sustainability nexus: Case study of MENA countries.

The new industrialization necessitates the integration of energy efficiency, economic development, and environmental sustainability. However, quantifying the efficiency of renewable energy towards economic development is an ongoing debate. On this basis, this study presents a multi net-put efficiency and conventional efficiency approach to analyze non-renewable energy and renewable energy efficiency towards economic development and environmental sustainability nexus. Data Envelopment Analysis (DEA) is utilized to estimate multi net-put conventional and renewable energy efficiency. Likewise, the Autoregressive Distributed Lag (ARDL) Pooled Mean Group (PMG) approach is applied to examine the impact of non-renewable efficiency on economic growth, total natural resource rent and environmental quality. Results show that the efficiency nexus of conventional energy is significant and higher (98%) than renewable energy (69.5%) for the evaluated period (2006-2016). Nonetheless, conventional energy efficiency of the panel of MENA countries worsen the environmental quality, thus does not enhance environmental sustainability especially in the long-run. The results also posit that economic growth in the panel of MENA countries is detrimental to the region's environmental sustainability. Further analysis indicates that the inefficiency of renewable energy nexus has more to do with scale size inadequacy rather than operational deficiency. Therefore, resources and policies must be targeted towards up scaling renewable energy capacity accompanied with cautious and target oriented strategy.

Transnational resource generativity: Efficiency analysis and target setting of water, energy, land, and food nexus for OECD countries.

Depletion of natural resources needs quantification and efficiency analysis of the use of resources to improve sustainability. This paper evaluates the efficiency of Organization for Economic Co-Operation and Development (OECD) countries in terms of Water-Energy-Land-Food (WELF-Nexus) to ensure sustainability and environmental viability for both present and future generations. An input-output index system is built at a transnational level. Composite and intrinsic indicators are introduced to incorporate the interconnections and tradeoffs between sectors of the nexus and outcomes of the nexus. The nonparametric benchmarking order-α model, resulting from Data Envelopment Analysis (DEA) is used to estimate WELF-Nexus efficiency of each country, and to alleviate the intricacies of using composite and intrinsic indicators. To ensure resource generativity, an output target setting model that accommodates predefined input is proposed. Results show variation in performance among OECD members, with an annual average efficiency score of 68%, 69% and 78% in 2007, 2012, and 2016. Sensitivity analysis was performed to measure the effect of drought on WELF efficiency, a decrease of about 13% on average WELF efficiency was observed. Outputs improvement was recommended for each country: Lithuania (14%), Mexico (10%) and 11% for Hungary, Latvia, and Turkey due to their high inefficiency. The study provides a robust framework for policy making and shows that a win-win strategy for the nexus must be implemented to achieve WELF-Nexus efficiency, given the trade-offs within its sectors. Furthermore, it highlights that innovative-driven policies will enhance WELF-Nexus efficiency and sustainability.

Efficiency Analysis of Healthcare System in Lebanon Using Modified Data Envelopment Analysis.

The inflow of refugees from Syria into Lebanon necessitates a robust and efficient healthcare system in Lebanon to withstand the growing demand for healthcare service. For this purpose, we evaluate the efficiency of healthcare system in Lebanon from 2000 through 2015 by applying a modified data envelopment analysis (DEA) model. We have selected four output variables: life expectancy at birth, maternal mortality ratio, infant mortality rate, and newly infected with HIV and two input variables: total health expenditure (% of GDP) and number of hospital beds. The findings of the paper show improvement in the efficiency of the healthcare system in Lebanon after the widespread of the health system reform in 2005. It also shows that reduction in health expenditure does not necessarily reduce efficiency if operational and technical aspect of the healthcare system is improved. The study infers that the healthcare system in Lebanon is capable of withstanding the increase in health demand provided further resources are made available and the existing technical and operational improvement are maintained.

Estimating efficiency of Directive 2011/24/EU cross-border healthcare in member states.

Aim: Directive 2011/24/EU on patients' rights in cross-border healthcare facilitates EU citizens' access to and reimbursement for healthcare provided or prescribed in a member state other than the member state of affiliation. Materials & methods: The efficiency of cross-border healthcare policy is evaluated using data envelopment analysis of relevant items in Eurobarometer Survey on Safety and Quality of Care and Patients' Rights in the EU. Results: Our study shows policy inefficiency in 52% of the 25 EU member states included in the analysis. Addressing difficulties patients encounter while seeking reimbursement from their national health service or health insurer and reducing the number of adverse events patients experience when receiving healthcare improves policy efficiency. Conclusion: Our findings confirm that there is country-level variation in cross-border healthcare policy efficiency.